Clinical biochemistry: CSF patterns in meningitis: practice question

A Biochemistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Biochemistry · Clinical biochemistry: CSF patterns in meningitis

Sample item

CSF from a febrile adult with neck stiffness shows 1,800 cells/mm3, mainly neutrophils, protein 260 mg/dL and glucose 18 mg/dL with a simultaneous blood glucose of 100 mg/dL. Which condition is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Acute bacterial meningitis

Bacterial meningitis gives a neutrophilic pleocytosis with high protein and a low CSF-to-blood glucose ratio from bacterial and leucocyte glucose consumption. Viral meningitis has lymphocytes, normal glucose and mildly raised protein. Tuberculous and fungal meningitis show lymphocytes with low glucose and subacute presentation.

Option by option

  • A. Viral meningitis

    Viral meningitis has a lymphocytic picture with normal glucose.

  • B. Tuberculous meningitis

    Tuberculous meningitis has predominantly lymphocytes with low glucose and a subacute course.

  • C. Fungal (cryptococcal) meningitis

    Cryptococcal meningitis has few cells, mostly lymphocytes, and a subacute course.

  • D. Acute bacterial meningitis (correct)

    Correct. Neutrophils with high protein and very low glucose indicate a bacterial cause.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Biochemistry questions

Questions about this Biochemistry question

What is the answer to this Biochemistry question?

The best answer is D, Acute bacterial meningitis. Bacterial meningitis gives a neutrophilic pleocytosis with high protein and a low CSF-to-blood glucose ratio from bacterial and leucocyte glucose consumption.

Why is "Viral meningitis" not the answer?

Viral meningitis has a lymphocytic picture with normal glucose.

Why is "Tuberculous meningitis" not the answer?

Tuberculous meningitis has predominantly lymphocytes with low glucose and a subacute course.

Why is "Fungal (cryptococcal) meningitis" not the answer?

Cryptococcal meningitis has few cells, mostly lymphocytes, and a subacute course.

What concept does this question test?

It tests Clinical biochemistry: CSF patterns in meningitis in Biochemistry. Viral meningitis has lymphocytes, normal glucose and mildly raised protein. Tuberculous and fungal meningitis show lymphocytes with low glucose and subacute presentation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Clinical biochemistry: CSF patterns in meningitis?

Build one table of enzyme deficiency, disease, inheritance and key finding, then revise it by spaced recall. Then use the flashcards and the other Biochemistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.